Protocols for patient communication and emergency treatment during COVID-19

Guidance on the steps to take to ensure patients can receive care

April 30, 2020 6261

CDA is offering the following guidance on patient communication and emergency treatment protocols to help dentists protect their patients, staff and practice.

During temporary restrictions to suspend routine care in efforts prevent the spread of COVID-19, dentists must remain available to patients of record who require emergency care. Failure to treat patients or to refer them for treatment can create legal liabilities, including charges of negligence or patient abandonment.

CDA is offering the following guidance on patient communication and emergency treatment protocols to help dentists protect their patients, staff and practice.

Maintain clear communication with patients

  • Develop messaging on how your office is handling appointments and emergencies while the “stay-at-home” and social distancing orders are in effect.
  • Distribute messaging in places that are easily assessable to patients such as:
    • Your practice’s website.
    • Social media.
    • The front door of your practice.
  • Have protocol in place to ensure patients can reach a dentist or staff member who is either working remotely or via voicemail to communicate their needs.
  • If your dental office is not open for emergencies:
    • Appoint a dentist to handle your office’s emergency care.
    • Provide the dentist’s contact name and phone number to patients.

Screen patients for COVID-19 to determine if they should be seen for emergency care

  • Continue screening emergency patients for COVID-19 by telephone or a telehealth platform before the patient enters the office or is otherwise seen.
  • Patients who pass screening questions should receive emergency treatment at the dental office and not be referred to a hospital ER.

Minimum PPE requirements to treat emergency patients

  • Minimum PPE requirements for non-aerosol-producing procedures during PPE shortages:
    • A face shield.
    • Level 3 surgical mask.
  • PPE requirements for aerosol-producing procedures:
    • Powered air purifying respirators (PAPR) or N95 filtering facepiece respirators
      • N95 are only effective if properly fitted. Dental professionals should follow all fit testing recommendations for the type of mask employed.
    • PPE should be worn by all staff in the immediate treatment area.

Dentists who do not have the minimum required PPE to treat the emergency dental patient should request it from a colleague or local Medical and Health Operational Area Coordinator.

Ensure staff availability for emergency treatments

  • If a dental team member is able but not willing to report to the office to provide emergency care, employers should:
    • Discuss employees concerns and consider whether they fall under any legal obligations to follow paid sick leave laws, other leave laws or ADA reasonable accommodation.
    • Comply with local social distance protocols that provide clear and flexible practices to ensure staff safety.
    • Outline when and how emergency patients will receive care and the essential PPE that will be used.

If you do not have enough staff to perform treatment, refer emergency patients to another dentist with adequate PPE and personnel.

Should a patient of record claim their dentist was negligent, caused pain and suffering or abandoned the patient and if the patient reports it to the Dental Board of California, the board is obligated to investigate the claim.

Find more information in the dental practice interruptions FAQ and more at CDA’s COVID-19 information center.